My hellacious health care nightmare -- Obamacare has ruined me

[Liberty Belle]

I supported it until now but no longer.

Before I had very good private healthcare, not perfect, but decent. When Obamacare came along my healthcare provider pulled out of California. I priced other private insurance and they were all at least $200 more, some $400 more for care that was no better. I wound up with a Covered CA Blue Shield Silver PPO at the price-gouging rate of $650 that was a huge strain on our budget. That's TRIPLE what I paid just a couple of years ago, and about $150 higher than I was paying a year ago.

Then my husband lost his job.

He had 2 months severance pay but lost his insurance after 2 weeks. He couldn't get onto Covered CA so bought a COBRA plan. That apparently disqualified him from Covered CA for the rest of the year! He is also paying $650 a month. So together, with our only income unemployment we are paying 75% of our entire houeshold income on healthcare! We are earning just slightly over what it takes to qualify for Medicare, so that's not an option, plus in our area no providers are even taking Medicare due to low reimbursements, so I don't want that. They say we can't get off of it or onto anything more affordable until January by which time we could lose our house. Why on earth should someone with no job or substantial income not qualify for subsidized rates ASAP?

It gets worse. On Wednesday I was in a catastrophic car crash. A truck pulled out in front of me and I slammed into it at 40 mph. I thought I died; everything went black and I came to smelling burning (the airbag had deployed and crushed into my chest, feels like I could have a broken rib) My car is totaled. I can't get enough to afford anything else that's worth driving. I am hurt. I was taken by ambulance to a hospital not covered under insurance. I have a terrible plan under Covered CA and just found out its even worse than I thought. Today, still feeling terrible with sharp shooting neck pain and vision blurring, I went to the doc on my plan at the clinic 5 minutes from my house, where I assumed I could get care.

They said if I want to see an orthopedic specialist I would have to drive an hour away, through heavy traffic! From El Cjaon to Torrey Pines, for those who know San Diego. This is insane. I live in a major city just 5 minutes from a good hospital with great orthopedic doctors. I am in too much pain to go so far. This happened when my husband and kids were all out of town. But even if iI had a driver the pain is too much to even ride as a passenger and sit up that long. (People offered rides; I declined. I also have 2 big dogs, one just a puppy, and can't leave them all day to go that far, and felt like shit so just went home and drank wine until I could fall asleep. I was up all night last night because it hurts too much no matter how I lie down.)

I asked to change plans to a plan that would cover the closest hospital and orthopedic doctors. I was told I can't until January. I then said what if I refuse to pay the Covered CA and cancel the policy...can I go buy private healthcare to at least get the emergency care I need right now? They said you can't even buy private insurance now except during the Covered CA open enrollment period! I just sat down and cried and cried in the healthcare clinic lobby until they hauled me into a back room so I would stop embarassing them in front of other patients. Well they SHOULD be embarrassed.

How can this be happening in America? In California? If anyone here has any connections to the Obama administration, someone in the federal healthcare offices, or someone high enough up in CA to help please, please let me know. I did complain to my Assemblymember, a caring Dem who headed the healthcare committee in CA, before my accident and her aid said there is nothing they can do because the laws that are giving us trouble are all federal.

It's not the Republicans that screwed me over, it's the DEMOCRATS by taking away my good healthcare and sticking me with a piece of shit policy that's not worth the paper its written on. So I'm paying $650 a month for a plan I've never even used for anything significant and when I slam into a truck and injure my neck, I can't even get care!

What can I do? Who can I complain to? Can any help me, act as a liaison for me, do something? My health insurance agent has tried and tried to help but she's just hitting dead ends too. What if something really bad happens, like an embolism or clot like people can get after bad crashes? Where do I go? What do I do? I found out the only hospital covered is an hour from here!

[Frustratedlady]

1. Why isn't the trucker paying your expenses? He or his company should have insurance.

I had the same situation, except the idiot who pulled in front of me IS NOT insured. My state is going after him to either come up with the money for my health care and all auto repairs, so you should have both of them taken care of by his company.

[Liberty Belle]

5. Eventually he probably wlil have to pay

police report isn't final yet but a cop told me today they did find him at fault, not me. I only found this out AFTER going through the nightmare at the clinic; I was afraid to run up high bills just in case he tried to dispute fault or some witness gave a conflicting account.

But....it takes a while to get a settlement. Been thorugh this before years ago. Other side won't write a check for medical care until you sign a release saying you're okay and absolve them of liability. Obviously I can't do that until I'm healed up.

My own insurance WILL cover up to $5,000 in medical care but with the ambulance, ER treatment, tests, and doctor today I'm probably already close to that or over it. I have no money to pay more out of pocket especially if tests like an MRI or CT are ordered - an MRI in our area can be a couple of thousand dollars or more. Even an ortho consult can run several hundred dollars.

The only thing I can maybe do is ask them to accept a medical lien against the jerk that did this to me. But some places wont do that.

I know, because about 20 years ago I had an accident nowhere near as bad as this one, had to have medical liens filed against me. The guy who hit me had the legal minimum insurance and it wasn't enough to pay all my medical costs (including surgery) so i still got stuck with some of it long-term. The new accident, truck driver (big Ford pickup) has crummy insurance too...sounds like very bad deja vu.

[REP]

12. Settlement is for pain and suffering

Give the medical office the insurance info of the driver and have them bill them.

[Liberty Belle]

17. Well I'm definitely racking up pain and suffering....

And the healthcare industry is insufferable!

[artislife]

71. File a pip claim

[Liberty Belle]

109. What is a pip claim?

[artislife]

137. personal insurance protection

Both you and the other driver should have it with your car insurance. Call your insurance agent. You can use it to insure payment for medical. That means being seen by doctors pts..lmps..chiropractors etc. Xrays..

[Liberty Belle]

206. Thanks.

I think you're referring to the medical on the car policy? If so I' have tapped into that. But my fear is we're already over that $5,000 with the ambulance ride, ER treatment, xrays, and a few other things already.

[artislife]

218. Talk to your claims adjuster

Trust me, I worked in medical offices and we dealt with pip claims. You can run it through pip then off the other pip (possibly) and then through regular medical insurance. But you won't know until you speak to someone who deals in insurance in your state. There has to be a claim on the accident. Go from there.

[artislife]

219. It will help you get the medical attention you need.

I just know the sooner you deal with injuries, even 15 mile an hour whiplash does so much damage, the better quality of life you will have.


Sending you the best possible scenario vibes your way.

[Liberty Belle]

227. Thanks, finally a positive suggestion here--I will try that.

I did of course file a claim on the accident, and the good news is the police report shows it's the other driver's fault.

[artislife]

237. Great, you will be using his/her insurance then

The PIP should cover a lot of your expenses. Talk to your adjuster and best of luck!

[CreekDog]

192. Which provision of Obamacare ruined your life?

[Liberty Belle]

205. Paying 75% of our income for healthcare premiums the next several months,

which means we could lose our house.

[CreekDog]

214. Obamacare doesn't require you to pay 75% of income in healthcare premiums

I asked which provision of Obamacare has ruined your life and you say something that isn't in Obamacare.

[Liberty Belle]

228. There is a CA provision that conflicts with the ACA 9.5% limit on what you're supposed to pay

We've argued that the CA law shouldn't be legal because it violates the ACA, but so far nobody has changed it.

Now though our Congressional member has taken an interest and is looking at maybe asking the president to do an executive order so that no state could just ignore that 9.5% of your income as the max anyone should have to pay for healthcare (household total income). If he would do that, it would solve our problem and everyone else in this pickle.

[forthemiddle]

51. The hospital doesn't care

They do not get into 3rd party liability. When you get treatment you are required to sign a statement that says you are 100% responsible for the payment. How you get that money is up to you.
Now having said that, a lot of hospitals will wait longer for an accident payment than a regular one, but in the end the person getting the treatment gets the bill.
What usually ends up happening is that your primary insurance will pay the bill and they will go after the auto insurance unless the auto insurance assumes responsibilty right away.

[KentuckyWoman]

2. An obtuse reply

Liberty Belle, honestly I got nothin' as far as your situation.... only that I feel for you.

But wanted to stop in and remind folks that most states car insurance no longer covers your own medical costs in a car accident. You have to opt in for the medical coverage on the occupants of your own car. People tend to cheap it but it's worth the money.

Oh and that Liberty Belle's story is yet another reason why we need single payer universal medical care. Insurance does not equal access to medical care...........

[Liberty Belle]

9. Yes I have always supported single payer - Howard Dean had that right.

What we have instead is a "camel" created by trying to appease the stupid Republicans but even the Dems wouldn't stand up and fight for Single payer -- if they had the compromise might have at least been better.

[PatrickforO]

22. I'm mad at the Dems for that too.

No political courage at all, because I believe they could have made it happen back in 2009.

[Warpy]

33. Joe Lieberman single handedly stopped lowering the Medicare eligibility age

I could strangle that little worm with a smile on my face.

Medicare isn't perfect but it's so far ahead of the ACA the latter will never catch up, no matter how much "tweaking" they do.

[Fumesucker]

186. If it wasn't him it would have been someone else

Not that I don't loathe Joebituary but he's just a small cog in a corrupt system.

[Warpy]

193. Probably, and Congress was full of DLC dead wood at the time

but it's a nice fantasy that the age could have been lowered to 55 or so, the corporate expiration age when most folks lose their good insurance and have to scramble.

[Ms. Yertle]

48. Um,

no one was trying to "appease the stupid Republicans," because everyone knew that they weren't going to vote for a plan. No. Matter. What. If anyone needed appeasing, it was the conserva-Dems. If not for them, we would have had single payer.

[karynnj]

50. Howard Dean was not for single payer in 2004

Rather than cherry pick - here are many statements including those around 2004. http://www.ontheissues.org/Celeb/Howard_Dean_Health_Care.htm

Dean, like many other Democrats, opted for universal health insurance rather than single payer because single payer could not pass Congress. (Even Bernie Sanders in 2010 said there were only about 10 Senators who would vote for it. It is likely lower now as Senators on the record for being for it if it could pass included Kennedy, Dodd, Harkin, Rockefeller and Kerry. Kerry's and Kennedy's current replacements likely are for it - maybe Dodd's - but no way Rockefeller's or Harkin's)

More importantly, I hope that you get this settled - hopefully with the truck driver paying - and get on a better plan. Your experience and that of others shows that the government still needs to improve the requirements on what plans provide. There is something really wrong when plans are not really tested until they are actually needed.

My daughter, who is essentially healthy, complained every time she had to find a doctor for anything on our plan - remembering how easy it was the year she did her masters in London and was on the national health care system. One observation she had was that - unlike every American doctor - the national health actually used the health records she showed and didn't insist that tests recently done be repeated for them.

[REP]

3. The insurance of the driver who hit you covers your expenses, not your insurance

It would've been that way with your prior coverage. Car accidents are never covered by your regular health insurance.

Unless you were at fault; then your insurance covers. That's the "bodily damage" coverage.

[Liberty Belle]

10. Sometimes your car insurance covers and then goes after the other driver's insurance.

That's what GEICO did before but they will only front $5,000. That goes fast when you're seroiusly hurt.

[REP]

14. I had them bill the other driver's carrier

[VMA131Marine]

4. First thing I would do

is find a lawyer who will help you sue the truck driver who pulled out in front of you. That driver's insurance should cover any medical cost you have that are associated with the collision.

[Liberty Belle]

18. I may have to eventually

Right now my focus has to be on healing and making sure any/all injuries are diagnosed.

I'm exhausted, just wanted to sleep but spent most of the day dealing with all the hassles. Another of which was the tow company trying to make me come get all my stuff out of my car when it was declared totaled before it's hauled off, crushed andmelted. Lots of calls to get that mess straightened out too....They didn't even want to let me wait until my hubby got back in from out of town even though I can't lift anything.

Once i'm healed up (hopefully eventually) then I'll need to see if the other side is willing to make a reasonable offer. If they won't, it will be off to talk to an attorney. I do have a lawyer in the family though he's not a personal injury specialist.

It was not so hard before because I had savings, but that's long gone.

[truedelphi]

26. I don't know your entire situation but you may qualify

For MediCal. At least as long as your only income remains the spouse's unemployment.

Anyway you have my total sympathy. California is the absolute worst segment of the nation's healthcare system.

I did elder care for close to 19 years - and I watched as time went on, how greatly overall care declined, while profits at clinics, surgical centers and hospitals soared.

By the time I left that field in the mid-2000's, they were cutting up women's breasts and almost expecting the women to sew themselves up after the procedure. (Have to keep those hospital beds available! How else can a hospital be profitable?) I mean, a woman would have a full masectomy and be allowed only half a day more in the hospital - then sent home with a booklet containing wound instructions, which they were then supposed to administer by themselves!

Try taking care of a breast incision's care when your lymph nodes have been cut apart from under both arms! (The situation actually helped me financially, as women with surgical experience as nurses hired me to take care of them - they knew they couldn't do it to themselves.)

Anyway Obamacare is all about guaranteeing a continual skyward advance of profitablity of the big health insurance groups, and Big Pharma, et al.


Funny how people always change their minds when the situation they shrug off finally happens to them, and not to
someone else. For awhile my spouse and I were pariahs among the other Democrats we knew, who were All praise Obama for this, and All praise Obama for that, but then they lost their jobs and then their homes, and then they started to see the light. They also realized that although Republicans say Obama is a bad bad man because his middle name is Hussein, the real problem with Obama is that his middle names happen to be Goldman Sachs, and United Healthcare.

[Liberty Belle]

245. That's awful, sending women home a half day after masectomies.

You've nailed the problem on the head I think.

[pnwmom]

32. The other insurer will want to settle. So if you involve a lawyer NOW

you can probably get a financial settlement much more quickly that will allow you to concentrate on healing.

If the situation is clear-cut, they won't want a long drawn out court battle. They'll want to pay you off to make you go away.

[Starboard Tack]

35. Not "eventually". Do it now

Lawyers will work on contingency, and there is a lawyer's phone number on every bus stop in California.

[underahedgerow]

38. Please pay attention to this carefully.... GO TO A LAWYER RIGHT NOW! Do not wait, do not pass go,

GO find a lawyer and he will set about getting you the care you desperately need immediately.

The other side will NOT make a reasonable offer! Get real!!!! They are in the business of making sure they pay out as little as possible with the longest delay possible! You're already being screwed by one insurance company, you want to get screwed by more?

His insurance company has a lawyer and his job is to reduce the financial damages to his client to the lowest possible amount, and he's counting on you not having the information and ability you need to seek immediate maximum coverage and damages. Your lawyer acts in your interest, no one else's and his professional expertise is what you need to guide you through this mess.

And FWIW, find the meanest lawyer you can. Find the asshole you don't like because he or she will be the one to fight for you. I learned this the hard way. I assumed since I had decent health insurance at the time that my costs would be covered. VERY wrong!

The other key for anyone else out there listening is to absolutely get the maximum personal injury coverage you can get on your auto policy. Get the lowest deductible and uninsured motorist as well.

[vankuria]

108. The other side will not make a reasonable offer I can assure you

And please do not wait until you are healed! You need a lawyer immediately to get you the compensation you are entitled to. Please do not put this off or you will continue to have the same problems and they could get worse. Find a good lawyer and ask if they could make a visit to your home as your injuries prevent you from going to their office. Please do not delay, you need legal representation to get you the best settlement possible.

[Person 2713]

177. You should already have a lawyer . They will work with your insurance company

Get the police report finding you not at fault . Not eventually -you should have the lawyer already.

[Midnight Writer]

23. Right. Get a lawyer, and do it NOW.

Not only will he help you recover costs from the truck driver and his insurance, he will help you deal with your own insurance company. DO NOT accept a legal representative from your own insurance company without having an independent lawyer of your own who is representing YOU and no one else in the case. Seek health care immediately from the best qualified provider of YOUR choice and let the courts sort out the payments. If the facts of this case are as you stated, and you have honest legal representation, the rest will work out. The most important thing is to RECOVER YOUR HEALTH. Everything else is secondary. Nothing is more important than your health.

[pnwmom]

31. This is probably the best advice here. n/t

[Liberty Belle]

110. All well and good but I also have to get a CAR first before I can do anything

I only get 5 more days of a rental car. So working on that first, then I can talk to a lawyer and by then hopefully will have a better idea if the injuries are healing well or not. Hiring a lawyer doesn't get you money instantly, plus the lawyer takes a big cut.

But I do appreciate the advice and when it comes time to negotiate I definitely won't be doing it without legal counsel.

[Lars39]

178. The bills will start coming in soon....

You could wind up in collections. A lawyer right now would take those bills and write letters to those owed money, leaving you without the hassle of trying to pay bills you have no money for right now.

[Person 2713]

179. You can call lawyers on the phone . Crying ACA known imperfections may make you feel happy

like you got something off your mind but really gets you zip. Your lawyer would tell you about the truckers insurance
the bad or good of that coverage etc. should be the focus

[Liberty Belle]

204. But you're forgetting we were hurting BEFORE the accident

I'mnot looking to get rich off an accident though there may be something for what I've been through.

I'm looking to get a premium reduced to an affordable rate for healthcare. Do you think paying 75% of what we're earning for healthcare premiums is ok?

[Liberty Belle]

229. I have a lawyer in the family. But when the other driver has lousy insurance

there isn't much a lawyer can do - they can't get silk out of a sow's ear. The lawyer in the family is advising me free so far and will work to negotiate a settlement but only after we know the full extent of my injuries and I am healed up or know what treatment is needed if any. No need to pay someone 30% or more of what may not be a very big settlement, if his insurance sucks.

But what we're hearing is that in CA lately, at least San Diego, some cases are settling for very little. It's not a gravy train.

It's not the driver's fault that we have crappy insurance that's costing us too much.

He is responsible for the damages to my car, my property in the car, my medical costs, and something for pain and suffering.

Settling quickly would be a mistake, because there could be medical issues that take a while to show up. I know this, because once before I had an accident where nerve damage wasn't diagnosed until six months later. It can take awhile for atrophy of a damaged muscle to occur, only after the nerve has been damaged for a while. There are things like subdural hematomas that can be there a while before the symptoms become severe. So waiting as long as you can to settle a claim on an accident this serious is a good idea.

None of the attorneys want to deal with the ACA; that's what insurance brokers are for; there may be other kinds of advocates out there.

[YOHABLO]

27. Absolutely! Wrongful injury lawyers love this stuff.

[riderinthestorm]

6. The truck drivers insurance will cover this

Dont panic.

I am so so sorry about the accident



Please get to a Dr asap...

[Captain Stern]

165. Hopefully

Hopefully, the truck driver was driving a commercial truck. Commercial insurance limits are usually far higher than personal insurance limits.

If it's a private insurance policy there's a good chance that the car insurance won't even come close to covering medical expenses. Here in NC, the minimum coverage that is mandatory to have is $30,000 per person injured, $60,000 total to any and all folks injured in one accident, and $25,000 property damage. It appears that in California, they are even lower $15000/$30,000/$5000. That means that the most that policy would pay to the OP is $15,000 for the injury, and $5,000 for the car. After that, the insurance company is done. If the driver has assets, she chould could sue him or her personally, but if they have nothing, she's out of luck.

[alcibiades_mystery]

7. ...

[Liberty Belle]

16. Thanks for the laugh....

I needed that.

[kaycee22]

8. Auto insurance?

Since your injuries are due to an auto accident, shouldn't that be covered under your car insurance or the other driver's insurance?

[Liberty Belle]

13. Once the cost goes over $5,000 I have to pay up front and wait to get a settlement someday

from the other driver. So once it's over $5,000 (what my car insurance will pay up front) I then have to go through my own medical insurance crappy though it is, or do without care apparently. I'm probably already over $5k with the ambulance ride and ER treatment, couple of prescriptions and doctor visits so far.

[WDIM]

11. Universal healthcare is still what we need.

We should be able to go to any doctor or any clinic or any specialist and it should be cover under a universal single payer system.

I wish you the best of luck in your healing. One day the people in this country may understand that medical care is a universal right and should be universal for all people.

[Liberty Belle]

15. Amen, universal healthcare is the answer.

What happened to me could happen to anyone - we were not poor, just didn't have savings due to having put 2 kids through college and a couple of other financial setbacks. But now we're in dire straits.

[jwirr]

77. If "dire straits" means you are now poor then go to the local

welfare department and sign up for Medicaid. And for that matter if you are really poor sign up for all they can help you with.

Many middle class people have no idea what is available and they automatically assume that they are too rich to qualify. All they can do is say no but if you do not ask then they are not going to say anything.

[Liberty Belle]

207. We are $100 a month over the Medicaid or Medical limits.

Per Covered CA. We did ask. But thanks for the suggestion anyhow.

[flamingdem]

19. I did get an out of network doctor covered fully by Anthem ACA

Your situation is much more serious but the procedure is to have the doctor or their administrator explain that you need care there - it can be related to convenience if it's too far from your home - but best to work the specialty angle - that the closer hospital and doctors have what you need.

The logic is that they'll lose money sending you to the wrong person long run.

There should be advocates to help you. It's frustrating but multiple calls will get you people with different knowledge at Covered California. One in four approximately can get things done, and you can ask for a supervisor.

[Liberty Belle]

226. Maybe I should try again, but I already did ask for a Supervisor,

and did ask the doctor to refer me out of network, and both refused to help.

If I don't get better I guess I'll just go see who I want, run up big bills, and try to go after the guy who hit me. Or wait until I feel better enough at least to manage the drive to somewhere farther away.

[flamingdem]

256. You don't have to get an out of network referral

Call Anthem and they'll send you to a department where they look up doctors. Explain that the one far away or not who you want isn't qualified and you want to go with this other doctor and make up good reasons related to specialty or that you've seen them before, or say you have.

Then that doctor, or their admin will back you up to Anthem, you have to pay and they'll send a check ideally.

[pugetres]

20. I'm so sorry this is happening to you.

I'm sorry your husband was stuck with his decision to go with Cobra and now has to wait to enroll.

But, have you contacted your exchange to determine if your household's new lower income qualifies you for subsidies? If your income is that close to medicaid cut-off, I'm pretty sure your policy premium amount can be reduced.

You really should give them a call.

[FreakinDJ]

21. Yep - it was all for the insurance companies

[JDPriestly]

24. The answer is single payer with low deductibles and low co-pays and everything

covered. That's what they had in the four countries in Europe in which I lived for some years. And that is what we deserve here in America.

Even Medicare is not as good as what we need. We need single payer that covers our medical care.

Obamacare is better than many of the plans that had huge deductibles, but single payer is what we need. Cut the profits out and spend all the money on healthcare and we will all be better off.

For the money we pay for for-profit healthcare (and most of Obamacare is for profit), we could have great non-profit healthcare in which executives are paid reasonable salaries and the government makes sure that patient care is first and profits are not an issue.

[reddread]

41. we need to tightly control pharmaceutical companies

instead of the other way around.

[CountAllVotes]

176. The health care system in the EU is deteriorating rapidly

Believe me, I if anyone would know. Its going to hell in a handbasket over there thanks to the big mess they are in over there with Merkel in charge!

Obamacare seems to help some people and it is an absolute curse to others!!

& recommend.

[LibDemAlways]

25. I have a family member who lost his job in CA and was

forced onto Cobra to the tune of $750/mo. Being on Cobra made him ineligible for Covered Calif. for many months. When his Cobra eligibility ended and he was able to get on Covered California -- still unemployed by the way -- he too got the shitty silver plan for $650/mo. -- not worth the paper it's written on. Shortly thereafter, he had an issue that landed him in the emergency room and after one night was taken by ambulance to another facility. The worthless insurance paid practically nothing. He was responsible for the $6,000 emergency room bill and the $2800 ambulance ride. Why have insurance at all, especially ridiculously expensive insurance, if it's essentially worthless? I am a staunch Democrat, but I'm in agreement with you that in some cases the "Affordable" Care Act is anything but. Covered California is a ripoff. I hope you get the help you need for your car accident injuries and that the insurance company of the idiot who hit you pays up promptly. Take care of yourself!

[pnwmom]

30. I don't understand how he was "forced" into COBRA. In my state, you can choose

whether to sign up for COBRA or go into an exchange. The exchange offers better options, so that's what my son did.

[still_one]

34. Nobody is forced to sign up for COBRA. Even before the ACA, that was the case, so I am not sure

what the poster means.

[LibDemAlways]

63. The ACA was not yet in effect when he lost his job.

It was COBRA or hunt around for other expensive insurance. At least under COBRA, even though it was expensive, it was the same basically good coverage he had when he was employed. Six months after he went on COBRA, the ACA went into effect. However, because he was on COBRA he wasn't eligible -- which was, in retrospect, a good thing. When his COBRA eligibility finally ended, he signed up for the Covered California Silver Plan which, as noted by me and the original poster, is a giant unaffordable ripoff that pays little. Fortunately, he's now employed again and climbing out of the huge financial hole left by the health insurance industry.

[truedelphi]

106. Thank you for spelling out the in's and out's of what

Your relative had to deal with.

I would make one correction though to your post - he was not just hurt by health insurance industry - he was hurt by everyone in Congress who did not even try to gt us Single Payer Universal Health Care. Of course, they are all counting on the plush jobs for family members that the Big Insurers will no doubt provide them in exchange for this crappy crappy piece of legislation getting passed.

[pnwmom]

115. The OP was paying $700 a month for her individual policy in 2012 -- MORE

than she's paying on her ACA policy (which she reports as $650, just for herself).

And there's no reason, based on the low income their family has, that they shouldn't be qualifying for substantial subsidies under the ACA.

Also, her husband could have left COBRA when the exchange was set up. My son did.

Her story has a lot of holes and discrepancies in it.

[truedelphi]

184. you cannot just go and get on an exchange -

You have to have been at a certain level of poverty for some period of time prior to your wanting to get on The Exchange.

If I remember correctly -- you are a physician. You probably get a salary.

You have NO IDEA what it is like to be self employed, to not have that platinum policy that gives you a ton of goodies, in exchange for holding down your job.

Also, you do NOT live in California. This is a state with 37 million people. I gave up on the ACA, even though I qualified for the Exchange, because I could never get through on the phone lines. I finally decided that I would simply be healthy this year and hold my breath as next year I get MediCare.

Self employed people in my neighborhood have seen their monthly premiums go up $ 250 a month - at a time when our businesses are failing due to the fires here.

My doctor charges $ 100 more per visit than he did before the ACA. (Not his fault, his clinic made him do it.) Why this increase? Because the clinic's owners attitude is everyone has the ACA so it is only the Insurance World that is taking the hit. But that is the attitude - so watch as the government goes broke trying to keep up with all this.

Also, I can no longer even see my doctor - he just sent out a notice saying that due to an upsurge in his practice, and number of patients, he won't be available to most of us, unless it is a special matter. We will all be seeing the nurse practitioner instead.

One point two million people enrolled in the CA for the Exchange here in California, but there were no additional doctors or nurses. So now there is a long wait to see a doctor. If you can see a doctor.







.

[pnwmom]

185. LOL. I'm not a physician. But I helped my son pick a plan on the exchange,

and so I do know how it works. (I also helped someone else get set up on Medicaid.)

If you lose your job you have a choice between paying for a COBRA plan or going on the exchange. Losing your job qualifies you for the exchange -- you don't have to "be at a certain level of poverty for some period of time." The COBRA plans are usually expensive but a lot of people choose them because they're familiar. Unfortunately, if you take a COBRA plan and then wish you had a subsidized exchange policy, you have to wait for the next enrollment period. That appears to be what happened to the OP.

Yes, there can be long waits to get through on the phone lines, if you don't want to handle things online. My son had good luck late at night. I would have stayed on the phone as long as necessary if I were you. I hope you can get through without insurance as long as you need to.

There is a problem with a shortage of primary care doctors now, but that isn't Obamacare's fault. It would be just as much of a problem if we had Medicare for all. We need to take measures to encourage more doctors to choose primary care rather than more lucrative specialties.

[Liberty Belle]

240. you can't if you have severance pay.

That was the monkey wrench for us. He couldn't qualify for the exchange at a subsidized rate due to the severance pay, and once it ran out they said it was over 60 days from when he lost his job. They should go by when you lose INCOME. Even if they waived that 60 day rule, which at one point the said they might, they told us he still couldn't get a subsidy because his total income for the past year is over a certain % over the poverty rate. So even if it drops to just unemployment, they're going by what you used to earn.

[truedelphi]

258. ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^n/t

[Liberty Belle]

236. My premium went way down after that old post 3 years ago.

I got on a cheaper plan, and then once it had been enough years since my old skin cancer, it went down even more.

The subsidies were denied based on our past year's income. If you earned over a certain percentage of the poverty rate, it doesnt matter if you lose your job and our income goes to zero or just unemployment. That's a big loophole that should be fixed. It assumes that if someone in the family once had a good income, you can somehow survive several months of just unemployment. But the unemployment check barely covers the mortgage and utilites here, nothing left for anything else.

[Liberty Belle]

111. He could not do the exchange because he had 2 months severance pay,

so couldn't qualify for any subsidy. Without a subsidy it cost even more than COBRA.
He thought he'd do COBRA for 2 months, then get onto a subsidized plan when his severance pay ran out.
But they said once you have COBRA you're stuck until open enrollment.
But even if he had gone bare on health coverage (which is illegal) or got some stopgap somewhere he STILL couldn't get the subsidy until January, because they look at your last YEAR of income, not the current situation. He had a good job, and we're being penalized for having good income the first half of the year. But we don't hvae enough savings to tide us over for several months of this!

[Liberty Belle]

242. He had 2 months severance pay so couldn't get into the exchange

while he still had that income. He didn't want to be left with no insurance, so got COBRA. Now that he has no income except unemployment, he still can't qualify for 2 reasons...see the other threads here for details.

[tammywammy]

250. you need to be more clear.

He could have purchased on the exchange. You're upset because he didn't qualify for a subsidy because he was still receiving income from his former employer.

He could have purchased a plan off the exchange even without the subsidy instead of choosing COBRA.

[Contrary1]

28. I'm paying $891. monthly...

And still get to pay for $300 a month out of pocket on meds.

In a few years, those of us who are spending our savings on health insurance will be left with zero. Then, what happens?

[still_one]

42. What does that mean? Is that for just you or your family. What kind of plan is it? With Medicare

Part B, which is for your doctor visits, tests, and other services. Premium costs: Each month you pay a premium of $104.90. If your income is higher than $85,000, you have to pay a higher premium.

A drug plan for the middle tier would cost about 50 dollars a month, plus for non-generics, the out of pocket could be a lot more.

In addition, if you have a supplemental plan, or medigap, the monthly premium for a Plan F would be about 150 dollars. So if someone has Medicare with supplemental for themselves and their spouse for a Plan F, and the middle tier due plan, the monthly costs for the two people would be around 600 dollars a month.

A medicare Advantage plan would have substantially less premium.

That is why I asked what it means in your situation, because even for Medicare, premium costs could be substantially high depending on the plan one chooses, and who is covered under the plan.

Before the ACA, for a healthy individual, with no pre-existing conditions, a PPO would cost on average about 700 to 1000 dollars a month.

For your 300 dollar a month medications, that is a lot. One needs to know more information on your plan's coverage for generics verses non-generic out of pocket expenses, deductibles, etc. You might try GoodRx.com to see if they can offer you better prices. You could research a Canadian pharmacy. Just make sure it is accredited. Consumer reports and other places are good sources to help you determine how to find a legitimate Canadian pharmacy, through google.

If you are paying that kind of premium, you probably do not qualify for subsidies or Medicaid.

Until there is single payer, which doesn't look probable in the near future, there is not much one can do.

[forthemiddle]

54. I think she meant Medicaid, not Medicare.

[still_one]

59. I agree. I was trying to find out more details. I used the cost of Medicare as an example that two

people who have the expensive supplemental plan F could pay as much as 600 dollars a month for their premiums. That is why I was asking about details, especially if that was for just one person, or did not cover a family. I probably did not make it very clear.

In this particular case with a premium of about 900 dollars, there is no way that is under Medicaid, though it could very well be under the ACA without out being subsidized. Also, is it the Bronze, Silver, or Gold would be helpful also.

[Liberty Belle]

231. Silver.

And I meant Medicare, not Medicaid.

Our total premiums are $1300 not $900.

[still_one]

239. That's a lot of money. I hope things get better

[Liberty Belle]

244. I did, you're correct.

[Contrary1]

62. That's just for me...

My husband is on Medicare, I won't be 65 for another 14 months. He retired from HP a couple years ago. It was either take the offer, or risk getting dumped with nothing but his bootstraps. Two years prior to that, he was gifted with a 23% pay cut. (Thanks, Carly)

This premium is for a Silver plan, which was only a few dollars a month more expensive than the next lower one. It covers prescriptions enough to pay the difference. I am on five different medications, two of which are not available in generic form. No dental coverage is included.

You are correct, we don't qualify for any subsidies, and that's ok. Financially, we should be alright. I actually don't mind paying a bit more to help cover those who are unable to, but $900 a month is a bit hard to swallow.

There are no doubt others out there in a similar situation as the OP that won't fare as well. I wonder about them. What happens to those whose incomes are too high to qualify for assistance, yet by the time they make mortgage and/or car payments, pay for food and other monthly living expenses, can't meet their deductible or pay the premium at all?

[still_one]

70. That is expensive, no question about it, and you are not alone. When I got laid off, I didn't

qualify for the subsidy either, and the CoveredCa premium was actually more expensive than COBRA, so I went with COBRA. I consider myself fortunate though since I was able to afford the premium, about 700 a month, and my wife was on Medicare at the time. I am now covered under Medicare, for about a year, which is about 300 dollars a month for me plus 300 dollars for my wife.

If I had gone with the ACA, I would have taken the Silver plan also. The Gold was significantly more expensive, and the Bronze had a lot of out of pocket expenses.

That is the BIG problem, what happens to those whose incomes are just above the subsidy requirement, but can't meet both the insurance premium plus mortgage. It is a serious issue, and one of the biggest failures of the ACA.

So your husband was affected by the HP layoffs. That is awful. Probably the worst mistake HP made was putting Carly into that position. She sold HP down the river with the Compaq deal, and a lot of people lost their jobs in the bay area. A lot of us in California know all about Carly, and I hope others in the country realize what a disaster she was. She got her golden parachute. She did a different maneuver with Lucent, by extending credit to companies who did not qualify to make the bottom line look good, and left the mess for someone else to clean up.

Sorry for your situation. I hope it gets better. Medicare will make it better, but it will still cost.

Take care

[jwirr]

78. When you are truly poor THEN it is Medicaid.

[Liberty Belle]

216. So you understand. Nobody should have to pay that much for healthcare.

[pnwmom]

29. There's a lot here that's hard to understand. I'm afraid you might be getting bad advice.

For instance, when your husband lost his job, he should have had the choice between going on COBRA or going on the state exchange. What do you mean when you say he "couldn't get onto Covered CA."? Any time someone loses a job that is one of the life events that should qualify you to go immediately onto an exchange without waiting till January.

Obamacare premiums are based on a fraction of your income -- so would never be 75%. You're in a state with subsidized premiums, so it's strange that you can't get a sharply reduced premium -- like to less than 10%.

(You are right that COBRA is very expensive -- but that is not the fault of Obamacare. COBRA has always been expensive.)

Also, you say that you are earning slightly over what is allowed to qualify for Medicare. Do you mean Medicaid? Because I don't think Medicare has an income limit, as long as you're old enough.

I'm sorry this has been such a nightmare for you, and even sorrier about your recent injury. It isn't fair that you should have to worry about money and paperwork instead of just being able to heal.

I just wish I had more confidence that whoever has been advising you knows what he or she is doing.

[still_one]

37. There are a lot of details missing in these stories. Medicare doesn't have an income limit, but

Medicaid does. Also, under the ACA, subsidies would be given based on income. There are folks who fall slightly above those income requirements for the ACA, and their premiums could be quite substantial compared to someone who was subsidized.

"If you leave your job for any reason and lose your job-based coverage, you can choose to buy coverage from the Marketplace. This is true even if you leave your job outside the annual Marketplace Open Enrollment Period. Losing job-based coverage qualifies you for a Special Enrollment Period that allows you to buy insurance outside the regular Open Enrollment period.

When you apply through the Marketplace, you’ll learn if you qualify for lower costs on your monthly premiums on private insurance. You could also qualify for lower out-of-pocket costs.

Through the Marketplace you’ll also learn if you qualify for free or low-cost coverage from Medicaid or the Children’s Health Insurance Program (CHIP)." (Medicaid is Medical in California)

...

"You may be able to keep your job-based plan through COBRA continuation coverage. COBRA is a federal law that may let you pay to keep you and your family on your employee health insurance for a limited time (usually 18 months) after your employment ends or you otherwise lose coverage."

https://www.healthcare.gov/have-job-based-coverage/if-you-lose-job-based-coverage/

Which is exactly what you said.

There is not enough details in the original OP which indicated the person lost their job. Losing one's job is considered a life event, and they should have been able to apply for marketplace insurance without waiting for open enrollment. That makes no sense at all.

In addition, if someone loses their job they can estimate their future income to determine if they qualify for subsidies, not what they were making when employed. In that estimate they would include things like unemployment insurance, etc.

https://www.healthcare.gov/income-and-household-information/

The most important thing is what you said at the end. You cannot assume that because someone tells you something, it is necessarily accurate. Sometimes one needs to go through several people just to make sure you understand what the terms are.

http://www.coveredca.com

[Liberty Belle]

116. The "life event" has a huge loophole

He had 2 months severance pay. and they look at the past year's income, which was high; mine was more than too. Trust me we have argued with Covered CA people til we are blue in the face - I tried, my hubby tried and our insurance agent tried. We couldn't believe it either, seemed like a Kafkaesque nightmare.

We have appealed all the way up the line and even had our Assemblywoman's office fight for us, to no avail.

My only remaining hope is our Congressional rep, and her office is trying to look into this at the federal level and see if possibly there is some sort of executive action that they could ask the Obama office to take to protect people in our situation.

My suggestion to her is if you are laid off and your COBRA is more than 9.5% of your household income as the ACA says you should not have to pay more than that for healthcare, then you should be eligible for subsidized ACA plans immediately, with no waiting until open enrollment. I think she is going to suggest that, just heard from her aide late today.

[still_one]

153. That is terrible news. I have a question. If someone signs up for COBRA, couldn't they sign up for

the ACA at the next ACA Open enrollment time?

I am aware of the 9.5% rule. The other rule that I am aware of is if the cheapest coverage, the Bronze plan premium, would cost more than 8% of the household income coverage, that person is exempt from the requirement to get health insurance. However, that defeats the entire purpose of providing affordable health insurance.

Your case is an example among others that really needs to be addressed, but it does not look likely at all in the near future.

Hope things get better for you, and sorry what you are going through

[tammywammy]

156. Yes, they can sign up during the next open enrollment period. n/t

[still_one]

158. Thanks, that is what I assumed

[Liberty Belle]

223. Thank you for understanding.

Yes we can sign up at the next ACA open enrollment with lower rates in January, but that's a lot of months to keep paying such high premiums for 2 people.

I think the law should be changed so that if you lose your job and the total household income means you're paying over 9.5% for your healthcare now, you should IMMEDIATELY be eligible for a reduced rate -- why make you wait months and months for open enrollment? I could see maybe a 30-day waiting period, but no more. Unemployed folks shouldn't be paying more for healthcare than for their mortgage.

The answer shouldn't be throw out the ACA or turn a blind eye and pretend it has no problems. The answer should be to fix the problems (unless by some miracle we get a progressive Congress and president elected that would chuck this system and get us universal single-payer healthcare).

[Liberty Belle]

243. What I omitted in my original post

Is that he had 2 months severance pay so could not qualify for the subsidies under the Covered CA exchangte.

He couldn't have no insurance after losing the job, so got COBRA.

They woudn't let him cancel it once the money ran out. And Covered CA looks at your past year of income. If it's a certain amount over the poverty level, you can't get into the exchange until open enrollment and even then, it might not be subsidized or barely so as they look at your income over the last 12 months. We did report what our current and projected short-term future income is or can be expected to be,to no avail.

[Liberty Belle]

113. No, he had 2 months severance pay so they counted that as income.

It was a catch 22. It was not open enrollment and with income he could not qualify. But the minute they found out he'd got Cobra and his severance pay ran out, we were screwed. He had no idea when he got Cobra for those 2 months that he'd be stuck with it once we had no real income.

We DID argue til we are blue in the face that the limit on the ACA is 9.5% or so and that we should NOT have to pay 75% but the state won't budge; we appealed and everything.

And yes I meant MediCal

[Jesus Malverde]

36. Wow what a mess

Obamacare does not provide healthcare. It provides insurance to consumers and guarantees a profit to insurance companies.

I'm afraid your stuck and need to go to the preinsurance mindset, consider going to Tijuana and paying cash, you'll likely get better care than you can currently in the states.

[YabaDabaNoDinoNo]

40. Truth! 'Obamacare does not provide healthcare.

It provides insurance to consumers and guarantees a profit to insurance companies.'

Is EXACTLY WHY the ACA Sucks Donkeys.

IT is half assed CORPORATE Solution to a REAL problem.

Never forget we the PEOPLE could have had Single payer but the DINOs made sure it did not happen

IT is the QUALITY of the Democrat that is more important then the quantity.

[still_one]

43. and exactly where would they have gotten the votes for single payer? The blue dogs had made it very

clear they would not vote for a public option or single payer. Both Nelsons, Lieberman, Bayh, and enough others closed that door.

The assertion that "we the PEOPLE could have had Single payer" is just not accurate. "we the PEOPLE", voted for those representatives and senators.

As for your statement "that it is the quality of the Democrat that is more important then the quantity", you obviously do not understand how the government works, because you are very limited in what you can accomplish if you do not have the majority.

The country is made up of many groups of people, and those living in the South, do NOT always have the same goals as those in the Northeast, and other parts of the country.

[YabaDabaNoDinoNo]

46. I understand very well how gov works and I also know the blue dogs, conserver a dem

Last edited Sat Sep 26, 2015, 09:24 AM - Edit history (1)

third wayers corporate whores are NOT Democrats despite how they lable themselves.

We will not get any change as long as the corporate dems are elected into office.

Yup I agree the South and Midwest are completely different places one damn near needs a passport to travel to them now that is how foreign they have become to the rest of America.

[still_one]

60. All I was pointing out is the argument has been put many times that we had a chance for single payer

back in 2008, and we blew it is not accurate. We didn't have the votes. Until the views changes in certain geographical areas in the U.S. it doesn't look likely for now

[nationalize the fed]

47. Wouldn't it have been helpful

if Senator Max Baucus (D-Insurance) hadn't had Single Payer Doctor and Nurse advocates arrested at a hearing?

Baucus’s Raucous Caucus: Doctors, Nurses and Activists Arrested Again for Protesting Exclusion of Single-Payer Advocates at Senate Hearing on Healthcare

With Video:
http://www.democracynow.org/2009/5/13/baucus_raucus_caucus_doctors_nurses_and

Max Baucus was rewarded for his actions with an Ambassadorship to China, where he is no doubt continuing to work very hard for the middle class.

Obama (and Reid) both promised a public insurance option, shame they didn't keep it.

Reid

[still_one]

61. No argument, Baucus was not the best person for what we call the ACA. However, regardless, when the

public option, and even when Medicare for those 55 and older was suggested the same usual suspects said they would not go for it.

No question, they should have not only allowed more input from single-payer advocates, they should have given those alternatives more exposure. However, I do not believe it would still have enough votes.

Their strategy at the time was obvious. They essentially used the Heritage Foundation plan as a starting point, which was also similar to the plan being used in Massachucets from Romney, thinking that it would be easier to get some republicans to sign on. That strategy failed miserably. They did not realize just how much the republican party had transformed itself into an extremist right wing political entity. It should have been obvious though.

While I do believe they could not have gotten single-payer or a public option passed at that time, they could have passed something that was simpler, and more affordable for more people. There is no doubt in my mind it is better than what they had before, but far from perfect, and until we get a more progressive Congress, it will be difficult to see any enhancements in the near future

[Recursion]

72. Baucus's idea was statewide insurance co-ops

Which, honestly, given how ACA is turning out might have been better. (It's roughly what Germany does.)

[still_one]

79. I don't buy the argument that the ACA is a complete disaster, it has helped a lot of folks

Health insurance through statewide coops, probably is the way they will need to go for single payer, except it will be one state at a time

[Recursion]

80. Oh it's definitely done a lot of good

I just mean that from a structural perspective I think Baucus's idea might have been better. But that ship has sailed.

Personally I'm coming around to just having the government set the prices of all drugs and procedures and devices, much much lower than they are now.

[still_one]

84. That is essentially what they do with Medicare. Problem is in some states like Texas, a lot of

physicians refuse to take Medicare or the ACA. Though I think most of the major medical facilities do.

I didn't realize that Baucus wanted to start from state COOPs. You educated me on that one

[Recursion]

90. That was just noise from the Hill; maybe Roll Call ran the story?

It's an interesting idea, at least.

[Liberty Belle]

238. Yes, one thing I'm upset with is Obama

It would be one thing if he'd actually tried to use his bully pulpit as president to advocate for single-payer universal healthcare. Starting there could at least have forced Congress to compromise some more to get something better than we got. By automatically saying that's off the table, he went in with a far weaker negotiating position and we got something that's weak in some areas, and is gouging many middle class people. It's great for the poorest folks, but not the newly poor trying hard not to lose it all.

[Jim Beard]

39. I buy some of my medications from Canada which is a huge savings even over Medicare part D

Advair is the main one ...........apparently Canada made Advair get on its knees and beg to get on their exchanges.

[still_one]

44. The only thing one needs to do is insure the Canadian pharmacy is an accredited one, and reliable.

[underthematrix]

45. I love my Obamacare. I have medicare now and my Obamacare was

much cheaper and better. i wish I could keep it but I had to switch. And I'm in CA.

When we looked for our Obamacare plan we did a lot of researh and came up with a clinic and hospital within five miles of where we live. Of course specialists are farther away usually in another city about 30 minutes.

my heart goes out to you. I would call Health and Human Services whihch oversee Obamacare. Maybe they can assist you.

[Liberty Belle]

235. Good suggestion, thank you.

I am glad that your Obamcare worked out. It has for some people, just not for everyone.

[displacedtexan]

49. Job loss qualifies your husband for covered ca without waiting for the new enrollment period.

Someone has given you really bad info. There is no way that Covered California would take 75 percent of your income for insurance coverage. I just talked to my Kaiser rep next door, and she says your application info must be grossly inaccurate if you're telling the truth in your post.

Also, no one loses insurance so quickly after a job loss in California, and no one is forced to stay with Cobra.

Call Covered California and a lawyer immediately. Something is really wrong with your situation.

[pnwmom]

56. I hope she reads your excellent advice.

[still_one]

64. You are correct, no one is forced to stay with Cobra, but if someone loses their job, California or

anywhere, they can lose medical insurance quickly. Unless the company will carry the insurance over for a short time, their current insurance will usually expire at the end of the month in which they were let go.

You are also correct, that losing one's job is a life changing event, and they would have been eligible for the ACA, (CoverdCa), even if it wasn't during Open enrollment. We really don't have enough details, but when a person loses their job they should contact the exchange ASAP, and start the process going. I believe for the income requirements, they can estimate their future income, and not have to take the income they were making before they lost their job.

Too many details missing, and I pretty much agree with you analysis and suggestions

[Liberty Belle]

114. No it doesn't. No energy to retype over and over.

We talked to about 10 different people at Covered CA, and our Assemblymember's office, and various other places. We are screwed because he had 2 months severance pay.

Your Kaiser rep is just wrong. My hubby used to have a good income and did hvae 2 mos. severance pay; thougth COBRA would be the right thing to do for 2 months til it ran out. Our application is ABSOLUTELY ACCURATE. We put every dollar in correctly. We have a reputable agent who helped us. She is astounded too, has appealed, fought, sent alll kinds of case examples, Covered CA won't budge.

And yes, you are forced to stay with COBRA. We asked over and over if he could just cancel it and go on Covered CA and were told repeatedly NO.

I am focusing on healing and will have to go after the guy who hit me to be repsonsible for any medical bills I incur due to the accident; thankfully I have no other health problems other than the injuries and just hope I can stay healthy and solvent until January.


Our agent even had a past case where they DID waive the Cobra deal and let someone cancel it, but they told us they've changed that "loophole" so now you cant. Grrrrrrrr

[LibDemAlways]

134. Thank you for again clarifying the COBRA problem.

Once on COBRA you are no longer eligible in CA for Covered CA until your COBRA eligibility expires. That's absolutely accurate. I witnessed what a relative went through who was on COBRA and wanted to sign up for the ACA. The answer was "you can't" until COBRA runs out. That doesn't address the problem though of the Covered CA insurance being basically worthless --which it is.

[Joanie Baloney]

159. One more opinion and good wishes for Liberty Belle

I too was laid off and went on COBRA. I spoke with a CoveredCA rep and when we got to the part about "are you on an affordable medical plan with your company?" and I said well, I am on COBRA. The rep said the key word was "affordable". He said that in my situation (on unemployment) COBRA was NOT affordable and I could mark that box no. I chose a plan with Kaiser and I am still on it although COBRA ran out and now I am on Kaiser through MediCal (unemployment ran out now too). See it works!!



So sorry for your streak of horrible luck. Call CoveredCA and try the "affordable" approach. It's worth a try! Good luck!

-JB

[Liberty Belle]

212. We did, and so did our agent. They were very uncooperative.

However...my Assemblymember's office is working on this, and told me today they talked to someone higher up at the ACA that said I might be able to get my premium reduced. I have to fill out mountains of paperwork. I did this twice already and got turned down, but will try again and hope she finally found someone willing to be reasonable.

The ACA says no one should pay over 9.5% or so of your income for healthcare insurance, but there is a huge conflict in the CA law and the ACA, and we were told that's part of the problem.

[Liberty Belle]

234. Thank you for confirming that your relative had the same problems.

Nobody can believe it until they've been through it.

I probably wouldn't have believed it if someone had told me this could happen, either. But there is a long paper trail we have to prove it, and I've sent it to my elected officials.

They are trying work on fixing the legislation.

[Liberty Belle]

233. We have called covered ca many times.

The issue is that he had 2 months severance pay so could not qualify for the subsidies when he lost his job back in June. He had to have coverage of some kind, so bought COBRA.

Everyone here who keeps saying you can get Covered CA right away if you lose your job is wrong.

They would have let him join Covered CA but not with the subsidizes-- and the unsubidized rate is even hire than COBRA for him.

By the time his severance pay ran out it was over the 60 day window.

There are all kinds of trap doors in the Covered CA law unfortunately.

[cantbeserious]

52. Your Anger Should Be Toward The DLC Third Way That Would Not Allow A Single Payer Discussion

The establishment democratic party is bound tooth and nail to DLC Third Way Policy.

[Sunlei]

53. Get a Lawyer and call your car insurance company. The trucks insurance will pay, a Lawyer and your

insurance company should help sort this out for you.

With the Obamacare the tiny networks are an issue.

The State of Vermont worked out something where persons with Obamacare can use any Doctor they want. I think that should be National policy.

[valerief]

55. Oh, yes, the Republicans who killed a chance for healthcare in the 90s

and who continually, since 1965, want to kill Medicare. They're the good guys.

I'm paying $600/month for ACA. I wouldn't have even that if it were up to Republicans.

I sympathize with your situation, but know your enemies.

[pinebox]

57. I'm sorry...

I'm truly sorry what happened to you. I am
This is bothering me though...

It's not the Republicans that screwed me over, it's the DEMOCRATS by taking away my good healthcare and sticking me with a piece of shit policy that's not worth the paper its written on.

Actually it's not. The democrats didn't pick your policy, you did.
I hate to say that but it's kind of true. I don't think it's the entire party which screwed you over.

Let me tell you my story with the ACA because it saved my life and if it wasn't for it, I wouldn''t be here today. I'm a success story and a pretty big one at that.

This is off my personal facebook.

I was allowed in to the high risk pools of the ACA in 2011 after both my insurance carriers dropped me due to a very rare lung disease that's non smoking relating. I lost everything I basically owned and had to sell off all my belongings just so I could afford treatment. I was literally left to die after I was dropped. I was lucky and I lucked out. My Mom has a rare disease as well and was going to National Jewish in Denver (best respiratory hospital in America) to be treated. She spoke with her doctors about my condition & they agreed to see me. They took me in and went to bat for me with getting me in to the ACA. I was accepted.
It’s easy to say things are bad and all that jazz but the reality is, I wouldn’t be here today if not for the ACA. I couldn’t get care as I was considered uninsured and for my condition I can’t walk into a ER and get treatment. I may have lost everything I once owned, literally, because my monthly medical bills were close to $4k a month after prescriptions when I was insured but I am here, alive, breathing, and I am getting better. Am I thankful? Who wouldn’t be when they are facing their own mortality. You best believe it I am!

A year ago this past January I was able to finally have the surgery which I needed. I was on the operating table for almost 8 hours & spent a whopping 3 ½ weeks in the hospital. Half of the time in Surgical ICU and the other have was spent in the intensive physical & occupational therapy unit. My incision is 4 ½ feet long (I was literally almost sawed in 2) More than 55 pounds of bad tissue was removed from my chest cavity. I had home health care nurses come every single day to change my dressings and to check on how I am healing up for 5 months. After just a few short months, my life is starting to change and for the first time in many years I am able to literally breathe easily again. I will need at least 2 follow up surgeries to address circulation issues.

I’m an Obamacare success story! I’m here today because of it and for that, I am very thankful. It saved my life.

[Liberty Belle]

112. There was no other policy to choose!

Only other option would've been private healthcare that was even more expensive than the ACA policy and with worswe benefits.

I am sure there are many who had good stories with the ACA and I really don't want to see it ended, was rash in saying that, but I hope you will support me and those others in my boat by demanding to your representatives that they fix these terrible problems with the ACA so that nobody winds up WORSE off when they are in need.

I am glad it helped you though, what a nightmare for you.

[Liberty Belle]

247. I'm glad you were helped. I hope they keep whatever worked for you, and fix

the areas where people like me and some others who posted here are falling between the cracks.

[pinebox]

252. Sure!

It's not perfect by any means but nothing ever is when it's first implemented. Another reason why you should vote for Sanders who would effectively give medicare for all and make sure that everybody is covered, where as Hillary is against single payer.

[Codeine]

58. You also once claimed electricity was "leaking"

from the ground near wind turbines and hurting coyotes, forcing them to climb trees to escape the pain. The same electricity was also causing a cancer cluster according to your posts.

You are an unreliable narrator. Insurance doesn't work that way in California.

[tammywammy]

75. +1 n/t

[REP]

163. And that SmartMeters cause illness

It's coming back to me now!

[Liberty Belle]

225. They do. California's PUC got thousands of complaints from people

on this. I had a smart meter put right outside my bedroom window and had heart palpitations and ear pain/popping that began a day or two later. This went away every time I traveled and came back first night home. I finally had it removed and those problems cleared up and never came back.

They emit electo-magnetic radiation. Why wouldn't you think that could have some effect, at least on some people who may be more sensitive, just as some people have allergies or chemical sensitivities?

Just because you are a skeptic doesn't mean this isn't true. Republicans are skeptics on climate science and we all know that's real.

[Codeine]

251. That's the worst kind of bogus nonsense.

You're surrounded by that sort of "radiation" everywhere you go. Absolute poppycock.

[SheilaT]

65. Why does this sound like

a right-wing rant against the ACA?

Others have pointed out various flaws in the story. I'll just address the car accident part. Your own insurance should cover at least the first $5,000 of emergency room care. Amounts above and beyond that can be covered by suing the other guy's insurance. As others have said, get an attorney. Now. Don't wait.

One huge mistake a lot of people make in a car accident is not going immediately to the ER to be checked out. If you don't, and afterwards try to say that whatever issue you're having is from the car accident, you won't be able to get it covered. At least you went to the ER in the first place.

[Liberty Belle]

118. Not true

I'm a past Democratic central committee member here and still a registered Dem though a very disillusioned one right now.

Why are people being so mean nasty and hateful to someone who almost just got killed? I am telling the truth but sick of going over every point.

I DID go immediately to the ER to get checked out, by ambulance. I am not stupid. I am a journalist and if this could happen to me it could happen to anyone who thinks they are protected until you find out you are not.

[Fumesucker]

187. There are more than a few mean and nasty people on DU

Sending you positive energy Liberty Belle...

[Liberty Belle]

209. Needed that, thanks!

[Facility Inspector]

249. because someone has an opinion that differs with yours?

[Rex]

66. Mandatory health coverage and unemployment are a disasterous result.

Are there no programs to help assist with the ACA while both of you are unemployed?

[Rex]

69. Oh I thought she says she is unemployed.

Could it be a state by state thing? I live in Texas and have great ACA coverage.

[Brother Buzz]

73. I read this as an auto insurance beef, not an ACA issue

Liberty Belle should be championing no fault auto insurance rather than attacking ACA

In the meantime, Liberty Belle Better Call Saul.

[Rex]

74. Have not watched that show yet, I should because I loved

Bob Odenkirk on Adultswim.

[Brother Buzz]

83. I'm cable challenged

I have to wait for season two to be released before they post season one at Netflix.

[Liberty Belle]

121. Excuse me? The ACA is a HUGE problem.

Did you not bother to read all the problems we had with them BEFORE the accident? So you think paying $1300 a month for 2 people for healthcare when you're living on unemployment benefits is okay?

[Liberty Belle]

215. so you think paying 75% of our income for health premiums through the ACA is okay?

That has nothing to do with car insurance. Sure, car insurance could be better. But that's not what's making us go broke. And actually GEICO has been much kinder to us and more reasonable than the ACA.

While our limit is only $5K in medical through GEICO they don't care how you use it - chiropractic, acupuncture, medical tests, doctors, massage, whatever. I charged stuff to GEICO for now but am afraid we'll be over that limit because of the ambulance ride and ER treatment at a hospital that it turns out isn't on our medical ACA plan. I shudder to think of the bills that will soon be coming in.

I'm not that familiar with no fault insurance; maybe it's better but I do know the limits on car insurance are way too low in CA - just $15,000 per individual. If I have any substantial medical issues I could easily be way over that and if the guy that hit me is insured at the minimum level and doesn't have other assets, I'm still toast. That may have been enough years ago, but not today.

[Liberty Belle]

119. Nonprofit, no income, volunteering to run the magazine

currently due to lack of grants at the moment. But it violates my privacy for someone to post that because it identifies me by name on the site and violates HIPPA medical privacy so I have asked the moderator to remove that post and all responses that reference that.

[tammywammy]

124. You've posted that your the editor yourself on here, including your name

http://www.democraticunderground.com/10024124629#post112

I fail to see how this could be construed as a HIPAA violation.

Edited to add: there are no mods to remove posts. You would need to contact the admins.

[zappaman]

129. I'm confused.

Someone who has posted the name of their paper AND their real name is upset someone else mentioned the paper?

[tammywammy]

135. And that's not the only time she's mentioned being editor of East County Magazine.

Or even her real name.

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=364x1270554

[Codeine]

150. Oh, stop your silly threats.

Everyone here knows who you are. When you post your identity, your injuries, your place of employment, and your salary then I think it's safe to assume that's all pretty much entirely on you.

[Liberty Belle]

136. I asked the moderator to hide the post above

that mentioned a NONPROFIT where I VOLUNTEER (I am not paid currently and only have gotten expenses reimbursed the last few months. The nonprofit lost a major long-time donor and our rent got jacked up, and I took the hit rather than let others in even more need lose their meager writing incomes including one with cancer.

To others here, it is a violation of HIPPA laws in a thread discussion my personal medical condition to identify me by name or link to the website where I am a volunteer editor. Thanks for respecting my medical privacy rights.

[herding cats]

140. It violates no laws to mention something you've mentioned time and time again here yourself

Saying so over and over again doesn't make any more true. You've outed yourself here, and that's how Brother Buzz knew who you were.

The site isn't recreated each time you decide to make a post. The history remains, as do all the words you've said in the past.

Stop with this silliness.

[Codeine]

145. It doesn't violate shit.

You've linked to your identity numerous times. Regular posters know who you are. Nobody has violated any laws by being able to recall who you are.

[Liberty Belle]

117. moderator remove the post above - it violates HiPPA privacy by outing my identity and is false

The last several months there has been no income through the magazine that is nonproifit, just reimbursement for expenses. I am the founder and it has been a very rough year due to several other emergencies involving our parent nonprofit. But thanks for embarrassing and humiliating me even further. There was no need for that and I ask the moderator to please remove the post above as it violates HIPPA to expose my employment when I was discussing private medical issues.

[herding cats]

138. You've said here before that is who you are.

You're alert was bogus. Bother Buzz was just repeating your own words here about what you do for a living. That that ended in a hide for him was extremely unfair.

I don't ever get into these type of scuffles here, but in this case I'm making an exception. What you did to Brother Buzz was just dishonest, and I like him. He's never been anything but kind to me. You I was ambivalent about before now.

You're words about who you are and where you work. There's many, many more instances if anyone cares to look them up.

http://www.democraticunderground.com/10141165250

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=103x505826

http://www.democraticunderground.com/discuss/duboard.php?az=view_all&address=102x3923152

For the sake of full transparency here is the wording of your alert.

This violates HIPPA medical privacy laws and is false. They outed my identity in a post discussing private medical conditions. This must come down or I will have legal claim against DU. It is also false. The magazine is nonprofit, doing poorly, and I have not been paid anything except expense reimbursement in recent months. Please remove this and any other posts that referenced the publication where I am the editor and people would know of my private medical issues now. I use a pseudonym here, not my real name!

[tammywammy]

144. Bogus hide

Ridiculous.

She's posted numerous times that she's the editor of East County Magazine over the years. There's no HIPAA violations; she posted her own medical issues. No one knew her personal salary as editor of East County Magazine until she posted it. All anyone knew is that her household income was too high to qualify for a subsidy.

Just in case Liberty Belle, editor of East County Magazine, alerts on me: please peruse the Google results of her own posts mentioning she's the editor.

http://www.google.com/search?ie=UTF-8&source=android-browser&hl=en-US&q=liberty+belle+editor+site%3Ademocraticunderground.com#q=liberty+belle+editor+east+county+site:democraticunderground.com&hl=en-US&start=0

[herding cats]

146. Thank you!

I was on the jury and I said:

Juror #6 voted to LEAVE IT ALONE
Explanation: Everyone here knows who you are and that Nadine works for you. Don't be silly! You can't have it one way in one thread and another way in a different thread.

Even I know this information. That's how prolifically it's been stated here.

I suspect it was the threat of legal action against DU that lead people to hide the post. Which makes it all the more wrong if that was the case.

I'm sure Brother Buzz doesn't even know who I am, but he said something kind to me at a time when it left an impression. I remember his kindness, and I think he deserve someone to stand up for him when he has been unfairly targeted.

[Egnever]

255. Omg Nadine works for her

That explains a lot

[herding cats]

257. I'd like to make one thing clear.

I wasn't trashing Nadine. They just both like to link to their work and have mentioned quite often that it is theirs when they do.

[Codeine]

151. Since when is posting to a message board

with a global following a "private discussion" of anything?

You've basically entered a roomful of people and shouted "Hey, my name is Jill Smith and I work at McStinko's!" and then returned to that same room later and yelled "Hey, I have toenail fungus!" Don't start accusing that roomful of people of violating HIPPA because they can remember two separate pieces of information simultaneously.

[zappaman]

152. Wow.

I agree with you that you have issues.

[pnwmom]

85. Not a disaster under the ACA. She lives in a state with subsidies, as the ACA was intended to have.

She and her husband should be eligible for the exchange and would have had to pay a small fraction of their income (it maxes out at about 9% for people with incomes of about 90K)

When the husband lost his job, he didn't have to take the expensive COBRA plan. He could have switched over to the ACA.

Either she's getting extremely poor advice or she's misinterpreting it.

[flamingdem]

92. You are so right, after a job loss one can apply to ACA right then

It's called Special Situation or something like that.

The OP doesn't explain why they didn't try that but I do understand people are intimidated by the system and confused to the point that they make errors.

[pnwmom]

93. Right. I think the system is probably too complicated for many people.

When I helped my son choose a plan, we spent a lot of time going through all the choices and trying to figure out which would be the best. It wasn't easy.

[bettyellen]

94. But the enrollment period exceptions are clearly there top of the home page so I'm calling bullshit.

It's one thing to say you picked the worst plan- it's another to post false info that you tried and couldn't get it and blame Obama. I think the real ailment here is ODS.

[flamingdem]

96. Speaking from experience - my very intelligent friend was laid off

and was fairly useless in his ability to parse the rules of Obamacare. I helped him considerably and he got it together but not without a lot of off the wall thought processes and considering Cobra to avoid the half hour waits on line and in general what must feel like judgement whenever having to say "I lost my job".

If I had not seen this happen I'd be more suspicious.

Also, ACA has been great for me but I recognize middle income workers are screwed as always. It's just too expensive without a large subsidy and the networks are narrow on purpose.

My solution has been to go with Anthem in my area because they dominate the networks - so surprising that others refuse to think as I do - they learn the hard way when having to drive long distances but in other ways they have better doctors. Logic seems not to apply always with ACA. So many fears too, some justified, about not being treated as well as those with higher end coverage.

[bettyellen]

97. If the claim wasn't "couldn't get" it, I'd not be suspicious either....

But being as the basic eligibility rules are front and center and easy enough for a child to understand, I do believe it's deliberate bullshit.
Choosing care, filing claims etc, I agree it's a PITA.
But basic eligibility, nope.

[flamingdem]

104. I see what you mean

BS needs to be called, too bad no explanation is forthcoming.

Could also be that they made a mistake and don't want to elaborate.

[pnwmom]

100. There are a lot of trade-offs to consider, and so it is a complicated decision

for many people.

And a plan that looks cheaper on first glance might not turn out to be, if you need a doctor or hospital outside of the system.

Still, compared to the NOTHING that was available for many individuals a few years ago, this is a big improvement.

[flamingdem]

103. I've found it to be top notch so far

but I get a decent subsidy.

Before however I was paying over a hundred more and had a 6500 deductible! I had to be careful especially knowing zero was available for ambulance or emergency room - what a rip off - but there was no way to complain.

I am forever grateful to Obama for putting his political capital on the line for ACA and he did it partly for his mom, so glad that many won't share her fate as a result!

[pnwmom]

105. My son has also been pleased with his plan.

And one of his friends, whose student income is low enough to qualify for Medicaid, has had very good care also.

The major improvement would be better dental benefits (but they're not very good in group plans, either.)

[Liberty Belle]

224. We DID try that. We reported our change in circumstances.

We are not confused or intimidated. Neither is our insurance agent.

when you lose a job they look at your income for the past 12 months or maybe it's year to date. If it's a certain percentage over the federal poverty level, you can't get subsidies even if your income is now zero. They make you wait for open enrollment.

A layoff, if your salary was very low, would get you subsidized right way. If your income is higher, it doesn't.

We don't have substantial savings due to putting 2 kids through college and a bad accident a few years ago that sapped our savings, plus things like utilities and water bills in our area of CA going through the roof. We pay the highest electric rates in the nation with the drought, water is going sky high too.

[Liberty Belle]

120. N O HE COULD NOT!!!! HE HAD 2 MONTHS SEVERANCE PAY.

He did not qualify. He had severance pay - ie INCOME but no healthcare benefits after the job loss.

there seems to be no provision for this.

[Liberty Belle]

221. our 2 elected representatives are trying to get us some help.

I have a mountain of paperwork to fill out tomorrow; hope they can do something.

[Rex]

254. Goodluck!

Hope they can fix this nightmare for you!

[threethirteen]

67. I am so sorry to hear your story.

Because everybody has advice, I thought you might like to hear mine as well. *winky*

First thing I would do is get on Ca's disability if I had worked in the last 18 months.

I called Nancy Pelosi's office to complain about issues I and my husband are having with the ACA. They told me to call the state insurance commisioner (http://www.insurance.ca.gov/) and talk to them.

I too had a better plan before the ACA and have been forced into a new plan where I pay more for less, with no option to buy up. My approach is and was to pay more premium and less copay.

Husband OTOH had his care through his employer changed. Now he pays a monthly premium for a service he can't afford to use. This is the way I understand it, there is a max that Kaiser will pay out (about a hundred dollars) and once that initial amount has been exhausted, he has to pay out of pocket for further services and then be reimbursed. Here's the catch, we live in San Francisco and he makes a couple of bucks above the min wage here. Getting together the money he has to pay out for services before being reimbursed is impossible. I understand it is about $100. That's right people, we make so little money that collecting together $100 over bills, rent and other necessities of living is impossible. There is always too much month at the end of our money.

So I feel you. I think a lawyer is a good idea, but having the state behind you might be more helpful to you and more meaningful to the insurance company than a lawyer at first.

I wish you the best of luck. And if it were me, I don't own a house, I would just go and get help and let everyone figure it out later.

[Liberty Belle]

246. I was self-employed, can't get disability.

I did a smattering of work for other clients and mostly the nonprofit where i'm editor. Never was an employee so unfortunately disability isn't an option for me, as far as I know. If I'm wrong and freelancers/independent contractors can apply, please let me know. But they probably go off recent income anyhow, and my recent income has been close to zero.

[MineralMan]

76. Who's your attorney on the vehicle crash?

You should already have one, and that attorney should be working to get the other driver's insurance company to cover all of your health care costs deriving from the accident. There will be some other settlement as well, if you were not at fault in the accident, and the attorney will get paid from the proceeds of the settlement.

Do you even have an attorney? If not, call someone who specializes in auto accidents. You won't find one here on DU.

Take the steps you need to take to come out whole on this. If, of course, the accident was the other driver's fault. If not, I'm not sure how to proceed, but you appear to have said that it was the other driver's fault. You should not have to worry about all of this. Your attorney will handle the details. Get one!

[LuvLoogie]

81. Why couldn't your husband get onto Covered CA

Do you mean he couldn't get onto the website? Open enrollement deadlines wouldn't apply due to his life change of loosing his job. Did your husband get help from an enrollment counselor?

This statment is confusing as well:

"So together, with our only income unemployment we are paying 75% of our entire houeshold income on healthcare! We are earning just slightly over what it takes to qualify for Medicare, so that's not an option, plus in our area no providers are even taking Medicare due to low reimbursements, so I don't want that."

Are you guys Seniors? Wouldn't you automatically qualify for Medicare? If you are not seniors then income would be a factor in qualifying for Medicaid. But you mean that unemployment income puts you over for qualifying for Medicaid? (Medi-Cal) I would be surprised if that is the case.

Someone upthread mentioned Medi-Cal. You should get some counseling on this and apply.

Also, while your husband was working didn't his policy cover you as well? What is your age group?

[Codeine]

82. There's a lot of bs here.

This poster has a habit of that.

[bettyellen]

87. Does not pass the smell test one bit....

But this gambit- angry at Onama because they couldn't figure out how to use the insurance - was also used to call him a "piece of shit used car salesman" buy someone who has a new baby and chronically ill spouse but is getting but just fine after they straightened their shit out.
Same bullshit.

[X_Digger]

141. This post survived an alert.

ALERTER'S COMMENTS

I am an award winning journalist with 250 awards including 83 for my current news site. It's inappropriate to impugn my credibility this way with no evidence (but also no appropriate to mention where I work or rather volutneer in this thread due to HIPPA medical privacy issues, which is why I have not responded to this post to defend my reputation and out who I am.

You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Sat Sep 26, 2015, 10:18 PM, and the Jury voted 1-6 to LEAVE IT.

Juror #1 voted to LEAVE IT ALONE
Explanation: Numerous typos made me question 'award-winning journalist' status, so I question the alert.

award winning vs. award-winning
no appropriate vs. not appropriate
volutneer vs. volunteer

Also, post alerted on does not 'mention where I work' as alerter contends either.

Juror #2 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #3 voted to HIDE IT
Explanation: This needs to stop. Too many personal attacks. Hide!
Juror #4 voted to LEAVE IT ALONE
Explanation: No explanation given
Juror #5 voted to LEAVE IT ALONE
Explanation: Let it go...you can't expect compleat manners on the internet.
Defend yourself by telling them they are full of shit and let it be.
Juror #6 voted to LEAVE IT ALONE
Explanation: Oh for fuck's sake. HAve your cake, eat your cake. Choose one.
Juror #7 voted to LEAVE IT ALONE
Explanation: No explanation given

[Codeine]

149. My thanks to the jurors. nt

[Marrah_G]

188. Aww, they think they are a special snowflake!

(referring to the alerter, not you)

[Liberty Belle]

142. To the person here who questioned n my alert effort on this post

doubting I'm an award-winning journalist because I had typos, I HIT A TRUCK and am in pain and exhausted. If you want to rethink that and PM me, alert judges, I will send you links to the awards. I don't want the site published here due to my medical privacy and thanks to other judges who removed another post that had outed my identity.

But I don't appreciate someone saying I have a "history" when in fact I have a very credible history and could prove that to the judges if they cared to know.

Codeine maligns me with no justification but that's her style, hit and run.

[Codeine]

148. I did not out you, champ.

You did that when you ill-advisedly tried to use your fishwrap as a source of authority for one of outlandish claims about the Ocotillo wind farm. My post didn't name you, didn't identify you, and violated nothing.

You have no claim against me, and you sure as shit don't against DU. You dumped a pile of your personal info onto this site, not I.

[Person 2713]

180. Maybe you outed income made in the past year

[tammywammy]

181. She's posted her income on here before

Previously: http://www.democraticunderground.com/?com=view_post&forum=1014&pid=675938

And in this thread here: http://www.democraticunderground.com/?com=view_post&forum=1002&pid=7206682

No one would know her income, medical issues, how much she pays for insurance, her job, real name, etc if she hadn't posted it on here herself.

[Person 2713]

182. That's what I mean that although small, perhaps the income now needs to be stated as none

for insurance prem
he didn't out her as much as just bring up past conflicting posts
Your 2 links
one income
the other now no income
But yes no reason for hide here because the story has changed but maybe that's why she wanted a hide

[Marrah_G]

189. Aren't you special?

Seriously, get over yourself. You are the one who has posted over and over who you are, who you work for and what you do. You cannot have it both ways.

[Liberty Belle]

222. We are in our 50s, too young for Medicare and not poor enough, just barely.

He couldn't get onto Covered CA after losing his job because he had 2 months severance pay, so couldn't qualify for subsidized rates right away. He got a COBRA plan to cover those 2 months. But even after the severance pay ended, Covered CA still counts your income for the past year and if it's a certain percentage over the poverty level, even if you're now under the poverty level, they don't care and say you have to wait until Open Enrollment to get a subsidized rate. That means January for us, best case.

Yes, the Unemploment income, plus a small pittance that I make, couple hundred a month off a grant, puts us $100 a month over the limit for Medi-cal.

When my husband was working I chose not to be on his policy, because it was an HMO where a doctor committed malpractice on me in the past and was the only nearby doctor in a specialty I need. It was only a little bit more to buy a private policy, but then when the private company pulled out of CA, I could'nt get on with my husband's policy (past their enrollment period) and the ACA was my only option. It was a lot more expensive than I've been paying, and there wasn't a plan where I could go to good doctors I trusted near my home.

[totodeinhere]

86. The ACA was never intended to be a perfect solution. It was all that was possible at the

time and even it almost didn't pass. It has helped millions and the uninsured rate is at record lows. But yes some people have fallen through the cracks. All we can do is keep working on it. And electing Bernie Sanders would be a good start. He would work hard to try to find a way to get single payer passed.

[Liberty Belle]

133. I agree on Sanders

I believe he's the best best to try and fight for single payer if he gets a Dem Congress, though even Hilary would be far better than any of the right-wingers running on the GOP side.

I knew the ACA would not help everyone but I didn't expect it to HURT people.

[bettyellen]

88. Baloney - anyone eligible for Cobra is eligible for ACAor exchanges. Fix your OP or let the lie

Stand- and we will see your true intent here. Which appears to be spreading bullshit.

[tammywammy]

89. Here's the Covered California webpage about COBRA

http://www.coveredca.com/individuals-and-families/special-circumstances/cobra/

Just so more people don't just fall for the BS the OP is spreading. He was eligible for coverage under Covered California. He can enroll during the next open enrollment period since he chose COBRA.

Since, for whatever reason, she wasn't covered by insurance through his employer, during the next open enrollment period their insurance cost would go down since they're buying for a house with two people and not two individual policies.

[Liberty Belle]

122. WRONG WRONG WRONG WRONG

How dare you accuse me of BS.

He was NOt eligible for Covered CA due to 2 months severance pay that ran out a month ago. Yes he can sign up during open enrollment but we're stuck with the high rates unitl that kicks in in JANUARY. FOUR MONTHS of those high rates AFTER his severance pay ran out.Now do you get it? I suggest you think before putting foot in mouth and kicking a car accident VIICTIM who is down. What hateful people we have here.

[Marrah_G]

190. You should really just add "DON'T YOU KNOW WHO I AM?" to every post.

[truedelphi]

101. Are you aware at all that California is a state with 37 million

People and that the phone lines present a horrendous challenge to anyone seeking to get anywhere with the ACA and California covered health insurance exchange.

And even should you enroll, you then find out that everyone else and their brother has also enrolled.

I have many friends who were big fans of the ACA, until they discovered what it means that some 1.2 million people were added to the Calif. insurance rolls, without any additional doctors, nurses, physical therapists etc.

So now people who used to be seen by their doctor within three weeks are waiting five weeks.

There is also the cost factor. As Morgan Spurlock points out, the ACA doesn't work well for the self employed. We are expected to predict what our gross income will be, for the coming year, and then we are penalized if we end up making more money than we predicted.

The ACA works out best for people who work at companies big enough to pay for part of the insurance premium expenses. Those people also have the advantage that since their employer is paying out Big Bucks, they can turn to their employer if the situation they are in is poorly handled with regards to treatment or expense. And those employed by others do not have to get out their crystal ball with regards as to how much they will make the following year, so they don't need to worry about penalties.

Those of us who are self employed pay our whole premiums, and those premiums have gone up. My mechanic is now paying some $ 250 a month more than he was before the ACA passed.

And then the issue that most concerns me is that health care in California is a very sad and very deliberately mismanaged situation. You pay a ton to be insured, but what passes for health care in this state is pathetic.

[Liberty Belle]

139. So true. Back when employers provided healthcare it was so much better.

When I was a kid, Dad worked for General Dynamics for 30 years. The family's entire healthcare was fully paid - no deductible, no premium, never cost anything to go to a doctor. What a sad change of affairs in CA now.

Part of the problem was letting hospitals go for-profit. They used to all be nonprofit in CA.

The lack of cost controls as others here have noted is a big issue. I don't know if other states impose cost controls but CA sure ought to.

You're right about the self-employment problem, too. That's also an issue for me. I occasionally do some freelance work, some years a lot, some years almost none. There is no way to predict this. you are supposed to report every income change to the ACA but it's almost impossible to get through on the phones - you have to hold forever, and that alone is very frustrating.

[Liberty Belle]

143. You are poorly informed.

I don't know the law in your state but in California once you have COBRA you cannot apply for the exchange until open enrollment.

[still_one]

155. yup, that is correct, and it isn't just California

[bettyellen]

166. Nope -he could "get onto Covered CA " instead of COBRA and it's right there on page one...

so "couldn't get onto" is bullshit. They could not have read the first page of the website and believe that. Sorry.

[Liberty Belle]

232. You don't know what you are talking about.

He had 2 months of severance pay, so couldn't qualify for subsidies but had to have healthcare somewhere; Cobra was the only real option.

[bettyellen]

253. The ACA was an option- not something they "couldn't get". Subsidies? Not enough info....

[still_one]

154. Actually that is not accurate. The way it is now, once you sign up for COBRA you cannot sign up for

the ACA until the next open enrollment period.

[bettyellen]

167. yes but they could have signed up- and in that way, the OP is blaming Obama for THEIR CHOICE.

which makes it bullshit.

[still_one]

168. I think the OP is expressing short comings with the ACA which have adversely

Last edited Sun Sep 27, 2015, 04:38 PM - Edit history (1)

impacted their situation, and added some vibrato to express that frustration

What I don't care for is referring to the ACA as "Obamacare". It is a phrase coined by republicans with intent to criticize it. No different when the repukes refer to us as the "democrat party". I really wish we wouldn't utilize republican negative achromisms

[bettyellen]

169. you say vibrato, I say willfully inaccurate. a long winded "thanks Obama!" from someone who at the

very least did not read the first paragraph about qualifying for ACA, so claims they "couldn't" get it. That is baloney.
They know better, and did not fix it. Might as well be Fox news, because that;s how accurate this is.

[still_one]

171. Vibrato, Tomato... (sorry about that). It is an unfair rant from the OP for sure, and of course the

usual suspects use the opportunity to dis Obama, saying we could do of had single payer, when the reality was we never had the votes for single payer, a public option, or Medicare for those 55 and older

They had a short window to pass something, and it is far better then what we had before, and lives have been saved because of it. Could it have been better, of course, but this is what we got between the blue dogs, and folks like both Nelsons, bayh, Lieberman, etc. Sanders recognized the political reality of the situation and voted for it

[Dont call me Shirley]

91. I'm sorry this is happening to you Liberty. I almost died from lack of health insurance and not

enough income to pay privately.


Single payer healthcare for all!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

[treestar]

95. Under the ACA you get a policy and the amount you pay for it

is based on your income.

If your income is very low, you qualify for Medicaid.

California is very blue, and would not be one of the ones that didn't take the medicaid.

And CA may have additional programs other states would not have.

This is like Will Pitt's rantings, not a credible situation, just an attempt to trash Obamacare, which has helped millions with some story that has nothing to do with it. The truck story was a bad add, as in CA there would be lawsuits.

Association with "East county magazine" further erodes credibility.

[Liberty Belle]

126. We are $100 a month over the Medicaid or Medical limit a month

with unemployment as he had a good paying job before.

Please remove the reference to the nonprofit site where I am the volunteer editor as you are violating my medical privacy rights under HIPPA by identifying me in a thread discussing personal medical issues.

As for the site's credibilty it has won 83 major journalism awards including investigative reporting, consumer affairs journalism and news in the public interest awards.

[treestar]

147. Then you can get an ACA policy for a premium of far less

than it is worth. In CA, you would have a good policy.

Just not a credible story.

[Gormy Cuss]

175. The law is HIPAA and reposting info that you provided about yourself here is not

a violation of the HIPAA privacy rule -- it applies to health care providers, insurers and medical clearinghouses. DU is none of those.
You may object to your IRL identity being repeated here --that's only a potential TOS issue.

And BTW, you're also confused about Medicare vs. Medicaid (the latter called MediCal in this state.)

You don't seem to have a good grasp on the issues here -- perhaps you should heed the counsel upthread to hire an attorney with knowledge of the applicable laws.

[geek tragedy]

98. Medicare is means-tested now? nt

[Liberty Belle]

128. I meant Medi-Cal, the CA version of Medicare, sorry, misspoke on that. n/t

And yes, it is means tested if you are under 65, which I am.

[tabasco]

99. Glorious, etc., etc.

[pnwmom]

102. According to a 2012 post, you used to pay $700 monthly before Obamacare. MORE than now.

You say you pay a "price gouging" $650 now -- though you don't explain why, if your income is so low, you don't qualify for a huge subsidy.

But three years ago, before the ACA went into effect, you were paying $700 a month for your personal policy. And you also posted a about suing an HMO doctor for malpractice -- also unrelated to the ACA.

So I don't think you should shouldn't be blaming all your problems on the ACA.


http://www.democraticunderground.com/?com=view_post&forum=1002&pid=934510

July 12, 2012

Bingo. My deductible is so high, I've declined tests I need but can't afford.

$2,000 deductible. I need an MRI, but have no savings. Already had a couple other expensive tests, and still have to pay those off. I have to pay $700 a month in premiums too, just for me, because I've had cancer before and this is the cheapest I can buy. It's shameful! And I will probably die anyway one of these days if I can't get diagnosed properly because I can't afford thee tests.





http://www.democraticunderground.com/?com=view_post&forum=1014&pid=675938

Dec. 17, 2013

I know it helped many people including friends of mine. But my policy was cancelled. I'm in CA which decided NOT to let people keep their plans another year.

I can't qualify for subsidies and couldn't afford anything in the Obamacare because my income was a bit too high. So I'm stuck paying over $100 more a month for a lousy policy with a much higher deductible and higher copays with a company with terrible reviews,, and when they are forced to be ACA compliant in January the rates get jacked up another 5%. I already had my rates TRIPLED to get any coverage at all last year, so this is horrible. I can't afford it, but can't afford no coverage either. I'm 55 and wish they'd just let me go on Medicare early. This is terrible.

I should add I was on Aetna with a great plan. They pulled out of CA due to Obamacare. Then I was on Blue Shield, a better policy at slightly more. They cancelled me with no notice, too this month and I'm stuck now with CIGNA which had bad reviews. I have no other options. I am paying $550 or so a month now for ONE PERSON and it goes up 5% more in January.

How is this "reform?"??????? I head a nonprofit, earned only $8,000 a year last year but becaause of my husband's income I cna't qualify for anything. His income goes 100% for our mortgage, 2 car payments, utilities, food, property taxes, insurance for homes and cars, and virtually nothing else. We're in CA where cost of living is high, hihgest utilities in the nation. Damn, this is NOT what I voted for!


_______________________

And AETNA, your preferred provider, has been subjecting its customers to large and unjustified rate increases:

http://www.prnewswire.com/news-releases/policyholders-struggle-to-pay-covered-california-premiums-shows-need-for-rate-regulation-says-consumer-watchdog-300092917.html


June, 2015

In May, the California Department of Managed Health Care said Aetna demonstrated a pattern of unjustified rate hikes. The nation's third-largest health insurer in April raised rates by 19.2%, on average, for about 16,000 people covered by small employers. State officials asked Aetna for a smaller increase that would have saved these employers at least $11 million, according the Los Angles Times, but the company refused. Over the past two years, DMHC found two other rate increases by Aetna unreasonable.

[Liberty Belle]

123. That was for a couple months when I had cancer and then it went down.

It went up and down like a yoyo for awhile. Originally the ACA helped me but now it is ruining me financially.

But yes, the insurance companies are culprits too for the unjustified rate increase.

What's really needed and NOT in the ACA is price controls on the private insurance industry. CA's insruance commissioner Dave Jones had a bill and an initiative that both failed. They would have made insurers get permission from him before raising rates and they would have had to justify a need, just as other types of insurers (house, car, etc.) already have to do in CA. But not healthcare, they can gouge at will.

[pnwmom]

125. The real problem I think isn't the ACA -- it's California's lack of price controls.

35 other states have them. So we agree on that much.

But I still don't understand why, with your income situation now, you can't get a huge subsidy on your premiums through the state exchange.

And really: the time to get a lawyer is NOW. Making a phone call to a lawyer won't get in the way of your healing. And it could set in motion the means to getting significant financial help to assist you in your healing.

[Liberty Belle]

127. you're right about the need for price controls on insurance rate hikes.

An initiative to let the insurance commissioner here regulate the rate hikes failed, people are stupid and listened to ads the insurance companies bought that were very deceptive.

There is a waiting period - we DID apply but they told us they look at your income for the past year. Even though our income was all in the first 6 months of the year, it was enough to be over the amount where you can get subsidies until open enrollment. I was shocked and so was our insurance agent.

[phylny]

107. I am sorry for all your troubles.

Private insurance is better at times, but mine made me go an hour from my home, in the opposite direction of where I work, which meant a two-hour commute to work daily for five weeks for radiation because the facility near my work didn't take my insurance. I said, "It's not 'Jerry's Insurance R Us,' it's AETNA!"

Sorry, no.

So yes, the "duh" is we need single-payer, universal health insurance.

[Liberty Belle]

130. On your last point, the need for single-payer, I hope we can ALL agree.

[still_one]

157. I don't think anyone would disagree with that on DU. The problem is in the current Congressional

environment it doesn't look likely in the near future unfortunately

[Stargazer99]

131. Consider yourself lucky, my daughter died under your Conservative selfishness

from a perfectly preventable death if she had HAD a doctor's care. Working with no medical (a Republican ideal) At least you have your husband my granddaughter doesn't have her mother! Or is it you are the only one who matters?

[Liberty Belle]

132. I am very sorry for your loss but I am not a conservative.

I am a liberal with a very long record.

I don't want to take healthcare away from anyone but DO strongly believe the ACA needs to be fixed and strengthened and made affordable for middle class people who lose jobs.

I was rash in saying I no longer support the ACA but I do NOT support what has happened to us and hope others here will agree that anybody who loses a job and has premiums 75% of their unemployment should be able to get the subsidized premiums immediately.

I am deeply sorry for your loss though, and can't imagine your pain; I have a daughter myself.

[CreekDog]

200. Still waiting to hear which provision of Obamacare ruined your life

[still_one]

160. Nothing is worse than what you have been through, and I am so sorry for your loss. However, I think the

OP was simply pointing out the short comings of the ACA that should be fixed.

There is no doubt that the ACA has saved people's lives, and is so much better than what was before. It is tragic and unforgivable that something wasn't there when you needed it.

Please take care

[hunter]

161. You might learn to ignore medical bill collectors and how to live with a low credit rating.

You will learn to fight insurance companies to receive what they promised you.

It's the U.S. American way.

I'm pretty sure if my wife and I had been born in a true "First World" nation we'd be millionaires, and never would have experienced medical bills delivered in big fat padded 9X12" envelopes, like shit falling out of the sky.

The U.S.A. is not a true first world nation and never has been. We are a "developing nation" with the very most bad ass money laundering gangster bankers, a huge military, and nuclear weapons.

How do you fight that system?

[Recursion]

162. People forget that: we are a very rich developing nation

I can't stress that enough. We have a population with the size and heterogeneity that only developing nations have and so we face the problems developing nations do. And we're actually something of a success story from the standpoint of developing nations.

(If a million plus migrants per year keep moving to the EU, they may follow us down this path too.)

[Liberty Belle]

208. That is the sad reality for so many people.

Including a friend who had open heart surgery and another who had colon surgery. They can never get out of debt - and now Congress got rid of medical bankruptcies so you can't even start over that way.

The system is corrupted by the corporations.

[onpatrol98]

164. Sorry for your troubles...

Sounds like you got plenty of good advice. I wish you well in your healing process. Every new program will have to have some things worked through. States that care like California will figure out where the holes are and patch them. Nothing is perfect right out of the gate. ACA has helped a lot of Americans obtain insurance for the first time. It's not the same as health care, but I think we know under crushing hospital costs, getting care without insurance is almost impossible.

Sounds like your situation is still better than some. Good luck!

[dembotoz]

170. any hospital care thru emergency room should be coverered

[jjct2012]

172. Clarification

I am also going through some issues, insurance was through wife's policy and she quit. So now, we are trying to get either COBRA, go on mine or into the exchange. It's all expensive.

I would also look at temp insurance, maybe 90 days, that can get you to open enrollment periods.

Anyhow, I am a bit confused on things here. If you are married, and your husband has insurance, you should be able to go on his insurance. Why did you have insurance through another means (it doesn't seem it is through employer)?

If you are not working, and your husband lost his job, you would probably qualify for medicaid, or if you still make too much with unemployment, heavily subsidized Obamacare. I find it hard to believe unemployment income would take you out of subsidy range. I still don't get why you don't qualify for a subsidy. When you are unemployed, it's a change in status, and you can enroll in those plans.

Should have been part of any separation agreement you have.

Anyone?

And, as far as Obamacare, if it wasn't here the rates would even be more sky high, your old insurance Co. plan was probably going away anyway to be honest. That's the one thing I do know. No one has that "good insurance anymore" Most businesses are going to a High-Deductible plan anyway.

Something doesn't seem what's right going on here. I think you got bad info/direction, and should investigate this.

And, don't worry about going bankrupt. If you have insurance, even crappy one, usually deductibles are $10,000 and perhaps 20 percent co-insurance. It's a hefty bill, but I think having your house at risk for medical bills that aren't terminal illnesses is a bit much.

[WillowTree]

173. The OP has said repeatedly.......

.......that they didn't qualify for a subsidy when her husband was first laid off because the eligibility for subsidies doesn't just look at your current income, but at your income for the last year. Based on that they may not even get a substantial subsidy when they hit open enrollment in January depending on how long he's been out of work and how much he was making before.

You're also making some largely unsubstantiated assumptions about her previous plan and what would or would not have happened with that, but that's pretty much moot at this point. That was then and this is now.

Not to mention the fact that untold numbers of people have lost their homes due to unpaid medical bills "that aren't terminal illnesses". That's not a big stretch at all if there's a long delay getting the insurance carrier for the truck to take responsibility and start paying her bills.

[Liberty Belle]

241. That's all correct and sadly

What you say about January even being in question is true. We're both trying to get work and he has a small odd job lined up, temporary, couple of days - so far only enough that they deduct it off your unemployment check, no net gain. But if he starts earning a little over that, but not enough to live on, it could bump our yearly income up to where he still wouldn't get a subsidy even in January. It's so discouraging...why even try to find work?

But he has to, since unemployment won't last forever, and even small jobs stretch out how long the unemployment will last.

I'm looking for paying work too, but it feels like Russian Roulette due to the rigged healthcare system.

I used to look forward to being old enough for Medicare, but now all the providers are telling me nobody should want that anymore. The doctors are refusing to see Medicare patients because of low reimbursement rates and sending them to crowded community clinics instead. I took a friend to one over the summer. He waited 6 hours and finally had to leave without even being seen.

[WillowTree]

248. You're in a rotten situation, Liberty.

But please do get in touch with a decent attorney as soon as you can. I worry that, since you hit him, the truck driver's insurance may try to blame you for the accident by claiming that he had the right of way. You just never know. You need to have someone looking out for you so things don't get worse than they already are.

Thinking that brighter days are ahead for you. Hang tough. I wish you well.

[SheilaT]

174. It's not a violation of HIPAA

Last edited Tue Sep 29, 2015, 01:23 PM - Edit history (1)

for someone to link two pieces of information together, both provided by the poster.

It IS a violation of HIPAA if someone uses knowledge of a person's medical condition/treatment/whatever gained from that person's medical records, presence in a hospital or doctor's office and so on. Plus, I believe a person outside the medical system simply isn't violating HIPAA at all, no matter what they tell others.

So if I'm working the registration desk in a hospital(something I used to do) and I call up someone to tell her a mutual acquaintance has been admitted to the hospital, I'm violating HIPPA. If you go to the hospital to visit someone, and in the waiting area meet a friend who tells you someone else you both know is in the hospital, HIPAA is not violated because neither one of you works for the hospital.

A bit wordy, but I hope everyone here gets the idea. HIPAA is not a blanket of privacy cast over everyone's medical information, but applies specifically to those who work in a medical setting, and therefore are privy to such knowledge.

[stopbush]

183. A lot of wrong information in this OP.

1. A COBRA plan is offered through the insurance your husband had at his job. He has 45 days to decide if he wanted that plan. Once he accepted it, yes, he couldn't shop for another plan until this November.

2. There is an exception to "not being able to get insurance through Covered CA." Any life-changing event gives you a 45-day period to make a change, and losing your job and/or your insurance is considered life changing. Your husband should have applied for insurance under that provision. He could have included you in such an application.

Get a new health insurance agent. She's not helping.

[Liberty Belle]

230. We did claim a life changing event with the job loss. See my explanations in the other threads.

He had severance pay for 2 months, which prevented him from qualifying for the subsidized ACA, That's why he got the COBRA.Otherwise he'd have had no coverage at all.

We've actually talked to TWO insurance agents. One is still trying to help, looking for cases where exceptions were made. The other didn't seem interested.

[Marrah_G]

191. The ACA saved my life. n/t

[lumberjack_jeff]

194. a) It's only been two days. "Ruined" might be an overstatement.

b) The main way that Obamacare appears to have contributed to your problems is the fact that you dropped it when your husband was laid off.

c) my nickel bet is that if the trucker was cited and at fault, their company will be proactive in helping you with your medical bills to reduce the likelihood of a lawsuit.

In the absence of Obamacare, what would you have done?

[Liberal_in_LA]

195. my thought also.

[lumberjack_jeff]

197. To summarize the op

Last edited Mon Sep 28, 2015, 07:17 PM - Edit history (1)

in 2011 Husband and Belle had good insurance
in 2013 Husband had good insurance and Belle had expensive bronze plan.
Husband got laid off and opted to purchase COBRA.
COBRA was expensive.
She now has a neck injury and Belle's ACA plan won't allow her to switch plans to one with more convenient providers for several weeks.

But this thread isn't about Belle's husband. Once you strip away the irrelevant parts:
Belle chose the least expensive plan in which the contracted specialists were 23 miles away.
She was in an auto accident in which she was injured.
She can't switch insurance for several weeks.
It's the insurance's fault.

Assuming the income prior to the layoff precluded a subsidy, the layoff midyear should result in a big refund on 2015 taxes.

[tammywammy]

198. I don't read that she canceled her insurance

She wanted to switch plans and they told her she couldn't until open enrollment. She's saying they're paying 75% of their current income, apparently just unemployment, for her insurance plus his COBRA.

BTW, after reading the rules, there's no penalty for being without insurance if it's two months or less. They may be better off just canceling his COBRA for November & December and keeping your fingers crossed he doesn't get sick.

[lumberjack_jeff]

202. You're right. I read it wrong - I thought the issue was that she's uninsured.

The issue is that she's insured by a plan on which the nearest orthopedic specialist is 24 miles away.

As densely populated as San Diego is, there's probably a more optimal plan that offers a better selection of clinics nearer to El Cajon, but I'm not sure I'd describe the situation as ruinous. Last Monday, I had to visit my ENT 43.4 miles away... and I don't consider that even inconvenient.

I probably won't phone the White House to complain on her behalf.

Ruination is medical bankruptcy, and thanks to the ACA that isn't an issue anymore.

[tammywammy]

203. Ehh, I drive 25 miles one way to work.

I guess it's all a personal perspective. I don't think my drive is bad (30-35 min usually), but someone else may hate it.

But then again, if I was in that much pain frankly I'd crawl on my hands and knees to get to the appropriate doctor for relief. Others obviously wouldn't.

Edited to add: I'm also an analytical detailed fine print reader. I check all options before making decisions.

[Liberty Belle]

217. interesting thought...

I would be tempted except he has a health condition that needs a cardiologist to monitor it....

[Liberty Belle]

211. I didn't know contracted specialists were far away.

The clinic that my plan supposedly is through is about 2 miles from my house. They USED to have an orthopedist out here when I signed up but he retired and they didn't replace him.

I wanted a plan through another group at a hospital close by but on the last day I could sign up for the ACA, that group had a dispute with the ACA and was not available. It is now, once I make it to open enrollment, I can change to that one.

"Least" expensive plan is not true. There were cheaper plans. I thought a "silver" plan was good, better and more expensive than bronze. I couldn't afford gold and couldn't really afford silver but had no other real choice.

But the problems began before the accident. We'd been fighting for several weeks to get my premium reduced on the ACA after my husband lost his job, but the ACA refused. They also refused to let me add him onto the ACA at a subsidized rate, basing all that on the prior year's salary. Again, these problems all arose BEFORE the accident. We are being charged 75% of our total household income for healthcare.

So even with no accident, we would be in a lot of trouble.

I don't know about a big refund though.....I sure hope you are right on that point!

[Liberty Belle]

220. you're confused, I didn't drop Obamacare, I still have it but we are paying 75% of our income for it

And it isn't even covering what I need.

The "truck" was an over-sized pickup driven by an individual insured by a company known for minimum insurance, so he may not have much to go after. He owns his own small business so probably no separate biz insurance even if he was no company time.

Before Obamacare I had a good policy that let me go to doctors I liked. It cost a lot less than what we are paying now, and I could see doctors close to home. i could even go off-plan if I chose for specialists and still have some coverage at a reduced percentage.

For me this is not an improvement, so far, at least as far as rates and coverage.

I did benefit briefly in the past, when i'd been dropped by an insurer for a condition and the ACA made it so private insurers had to cover everyone. I got insurance again but at a lot higher rate than before; then that insurer left the state, and so did the next insurer I signed up for, and finally I had no other real option but to sign on for the ACA, but the choices aren't very good here and it costs even more.

[KamaAina]

196. Sounds like your beef is with managed care, not the ACA

Nothing in the ACA requires plans to make you drive all the way across San Diego to get to an in-network provider.

When Obamacare came along my healthcare provider pulled out of California.

Huh? The ACA is nationwide. Sounds like they were looking for an excuse to pull out of California.

[tammywammy]

199. Aetna pulled out of the individual market in California.

It was such a small part of their market share they decided to just pull out.

[Liberty Belle]

210. Yep I had Aetna before.

[SoCalDem]

260. I thought they merged with another company

[demosincebirth]

201. With your and your spouses income I'm sure Med-Cal can help

[ReactFlux]

259. Profit over People

the largest reason for personal bankruptcy in the U.S. is due to health related issues.

A national disgrace.